Intraoperative endoscope cleaning system

ABSTRACT

The disclosure is directed to methods and systems for cleaning scopes using a camera port (e.g. trocar) which has been modified to include a cleaning system. A trocar is a device designed to allow surgical instruments and tools to be quickly and easily inserted into a body cavity without contacting the surrounding tissue.

CROSS-REFERENCES TO OTHER RELATED PATENT APPLICATIONS

This patent application claims the benefit of U.S. Provisional Application Ser. No. 62/930,983, filed on Nov. 5, 2019.

BACKGROUND 1. Field of the Invention

The present disclosure generally relates to endoscopes, and more particularly to a system and method for maintaining a clean endoscope during a procedure.

2. Discussion of the Related Art

An endoscope is a medical device utilized for medical procedures requiring the visualization of internal organs in a non-surgical manner generally referred to as a minimally invasive procedure. A physician may utilize an endoscope to make a diagnosis and/or to gain access to internal organs for treatment. The endoscope may be introduced into a patient's body via a natural orifice or through a small surgical incision.

An endoscope generally comprises three systems; namely, the endoscope system, the imaging system and the illumination system. All three systems must work together to give the physician the entire, and clear picture. More specifically, in order to achieve optimal results, the physician must be able to have a clear view from insertion of the endoscope, traveling to the organ site and during the entire procedure. In order to do this, the lens of the endoscope must be maintained free and clear of any obstructing material, including smears, residue, debris and condensation without the need to remove the device from the body. Minimally Invasive Devices, Inc. has developed the FloShield™ system that directs carbon dioxide gas to the tip of the scope to clear the lens from condensation, debris and smoke. CIPHER SURGICAL has developed the OpClear® device which utilizes a gas-powered saline delivery system to clean the scope lens during a procedure.

While the above-referenced devices do function to clean endoscopes, these devices require additional components and are fairly complex in design and use thereof. For example, these devices comprise additional sleeves which are sized for particular endoscopes. For each endoscope, there is a sleeve and if a physician changes endoscopes during a procedure, which is a common occurrence, a new sleeve must also be utilized. In addition, these devices are fully manual device/systems which required the physician to perform additional steps and thus divert his or her attention from the primary task.

Accordingly, there exists a need for a simple, efficient and easy to utilize system and method for maintaining a clean scope lens and field of view.

SUMMARY OF THE INVENTION

Intraoperative endoscope cleaning systems are disclosed herein. An example intraoperative endoscope cleaning system may comprise a control unit, a wash solution reservoir, a gas supply connected to the control unit and a camera port (e.g. a trocar). The trocar may be connected to the control unit and the wash solution reservoir and configured for facilitation of an endoscope into a body of a patient and for cleaning the endoscope during use.

The example trocar may comprise a main body, an inlet port, a fluid channel, a cleaning orifice and one or more sensors.

The main body of the trocar may comprise a head portion and an elongate hollow tube portion extending from the head portion and terminating at a distal end of the main body, wherein the tube portion defines a cavity configured to receive an endoscope.

A connector port may be disposed through the head portion of the main body and configured to receive a bulkhead connector. The distal end of the tube portion may comprise a shaped end having edges. For example, the shaped end may comprise a first edge and a second edge opposite the first edge. The first edge may extend further from the head portion than the second edge.

The inlet port may comprise a single inlet port or a plurality of inlet ports. The inlet port may be disposed through the head portion of the main body and configured to receive a wash solution, a gas or both. The wash solution may comprise a buffered solution comprising a bio-compatible surfactant. The gas may comprise carbon dioxide or other gases. The wash solution and gas may be selectively received or may be received successively. Other materials suitable for cleaning medical devices may be used.

The fluid channel may comprise a single fluid channel or a plurality of fluid channels. The fluid channel may be disposed in or adjacent the tube portion of the main body and in fluid communication with the inlet port to receive the wash solution, the gas or both from the inlet port.

The cleaning orifice may comprise a single cleaning orifice or a plurality of cleaning orifices. The cleaning orifice may be disposed adjacent the distal end of the tube portion of the main body and in fluid communication with the fluid channel to receive the wash solution, the gas, or both from the fluid channel and to allow the wash solution, the gas, or both to flow toward the cavity. The cleaning orifice may be disposed adjacent the first edge. The cleaning orifice may comprise an angled port formed through at least part of the tube portion of the main body. The cleaning orifice may be thin-walled. The cleaning orifice may comprise shaped orifice designs (e.g., circular, oval, rectangular, etc.).

One or more sensors may be disposed on or in the tube portion of the main body between the cleaning orifice and the head portion of the main body. The sensors may be disposed adjacent the fluid channel. The sensors may be configured to sense a position of the endoscope within the cavity. The sensors may comprise a flexible circuit board. The sensors may be self-calibrating. The sensors may be coupled with lenses, as shown in FIGS. 7A-7F. The sensors may be in communication with the control unit. The control unit may be configured to execute one or more cleaning processes in response to feedback received from the sensors. The execution of the one or more cleaning responses may be automatic. The control unit may be configured to provide ease of use features such as visual and audible feedback to the user to aid in positioning of the endoscope. The one or more cleaning processes may be or comprise a de-fog operation, a priming operation or a wash and dry operation.

The de-fog operation may comprise expelling a burst of gas through the cleaning orifice. The de-fog operation may be triggered as the endoscope is retracted into the tube portion and passes one or more of the sensors, for example the distal-most sensor.

The priming operation may comprise loading an amount of the wash solution into the fluid channel. The priming operation may be triggered as the endoscope is retracted into the tube portion beyond a threshold.

The wash and dry operation may comprise expelling the wash solution from the cleaning orifice. The wash and dry operation may be followed by gas for drying. The wash and dry operation may be two seconds or less.

Methods of cleaning endoscopes during procedures utilizing trocars are described herein. An example method may comprise defogging the endoscope, priming the cavity, washing the endoscope, drying the endoscope or combinations thereof. The example method, or certain portions of the example method, may be executed automatically.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing and other features and advantages of the invention will be apparent from the following, more particular description of preferred embodiments of the invention, as illustrated in the accompanying drawings.

FIG. 1 is a diagrammatic representation of the endoscopic cleaning system in accordance with the present disclosure.

FIG. 2A is a perspective view of a trocar in accordance with the present disclosure.

FIG. 2B is a cross-sectional view of the trocar of FIG. 2A.

FIG. 2C is a diagrammatic representation of a trocar inserted into the body of a patient in accordance with the present disclosure.

FIG. 3A is a cross-sectional view of a trocar showing a sensor configuration along line 3A-3A in FIG. 3D.

FIG. 3B is a cross-sectional view of a trocar showing a lumen configuration along line 3B-3B in FIG. 3D.

FIG. 3C is a cross-sectional view of a trocar showing a sensor and lumen configuration from FIG. 3D.

FIG. 3D is a diagrammatic representation of a trocar.

FIGS. 4A-4E are diagrammatic representations of thin walled orifice designs of a trocar in accordance with the present disclosure.

FIG. 5A is a diagrammatic representation of a trocar.

FIG. 5B is a cross-section of the trocar of FIG. 5A taken along line 5B-5B.

FIG. 6 is a diagrammatic representation of a sensor system.

FIGS. 7A-7B are plots of example sensor settings.

FIGS. 8A-8F are diagrammatic representations of sensor configurations with FIGS. 8E-8F including lenses.

FIGS. 9A-9I are diagrammatic representations of angled endoscopes in accordance with the present disclosure.

FIGS. 10A-10B are diagrammatic representations of spray orifice designs in accordance with the present disclosure.

FIGS. 11A-11B are diagrammatic representations of trocar internal graphics in accordance with the present disclosure.

FIG. 12 shows diagrammatic representations of trocar internal graphics in accordance with the present disclosure.

FIG. 13 is a diagrammatic representation of trocar external graphics in accordance with the present disclosure.

FIG. 14 is a flow chart of the process in accordance with the present disclosure.

FIGS. 15A-15C illustrate an example lumen with features that cause moisture retention

FIGS. 15D-15F illustrate an example lumen with rounded edges and smooth transition between surfaces to minimize retention of moisture.

DETAILED DESCRIPTION

The present disclosure provides simple and efficient methods and systems for cleaning endoscopes in-situ. An example device may be integrated into a trocar and comprise a semi-automated washing process. The systems and methods of the present disclosure are suitable for both traditional and robotic medical procedures.

The present disclosure is directed to methods and systems for cleaning scopes using a camera port (e.g. trocar) which has been modified to include a cleaning system. A trocar is a device designed to allow surgical instruments and tools to be quickly and easily inserted into a body cavity 112 without contacting the surrounding tissue 110.

Referring to FIGS. 1-5 , a cleaning system 100, for example an endoscope cleaning system, of the present disclosure may comprise a trocar 200, a control unit 102, a tubing set 104, a wash solution reservoir 106 and a gas supply 108, for instance a CO₂ supply. The trocar 200 may comprise main body having a head portion 201 and a hollow tube portion, such as a scope lumen 210. The head portion 201 may taper to the scope lumen 210. The head portion 201 may be configured to receive a cap 203. The head portion 201 may comprise one or more ports 208, 300 to couple other devices to the trocar 200. Other configurations may be used. The scope lumen 210 may configured to receive a device such as an endoscope 103. The trocar 200 may comprise a cleaning lumen 204 (e.g., channel) that may run the length of the trocar 200 (or a portion) and exits through an orifice 206 at or adjacent the distal end thereof. The scope lumen 210 may be configured to pass through body tissue to allow a device such as the endoscope 103 to move through the trocar 200 and into a body cavity (FIG. 2C).

A sensing system 300 (e.g., sensing strip FIG. 6 ) may be disposed in or integrated into the trocar 200 to detect the scope position and provide feedback to the control unit 102. The sensing system 300 may comprise an electrical circuit 302 and one or more sensors 304. As an illustrative example, the sensors 304 may be configured to indicate a position or function. As a further example, sensor 304A may be configured as a “scope present” sensor indicating the presence of a device in the cavity such as an endoscope. Sensor 304B may be configured as a “prime” sensor indicating a position of the scope that may trigger a priming of the wash solution channel. Sensor 304C may be configured as a “wash” sensor indicating a position of the scope that may trigger a wash process. Other positions and triggers may be used. The electrical circuit 302 may comprise a circuit board such as a flexible circuit board. Other circuits and electrical pathways may be used. The sensing system 300 may comprise a connector 306 such as a bulkhead connector. The control unit 102 may monitor one or more scope sensors 304 and upon detection of the scope 103 may activate a wash cycle, for example, comprising a wash followed by a dry. As a further example, to achieve this, the control unit 102 may prime the lumen 204 with a fixed quantity of wash solution then activate the gas dry. The gas acts as a propellant creating a very brief high energy spray (FIG. 3B) out of the orifice 206 and once the wash solution is consumed the gas acts to dry the scope 103. In this way the scope 103 is cleaned intraoperatively (without removal from the patient) and with minimal input from the operator, the operator simply requiring retraction of the scope 103 into the trocar 200.

The washing solution may comprise any suitable biocompatible material, for example, a saline solution. In preferred embodiments, the washing solution comprises a buffered solution and a surfactant. Carbon dioxide is the preferred gas to utilize for several reasons, including biocompatibility and the body's ability to absorb the carbon dioxide. The gas may be supplied from a dedicated tank or from the surgical suite supply. The gas may be supplied at a pressure in the range from about 10 to 30 psi and preferable at 30 psi.

As shown generally in FIG. 1 , the control unit 102 is connected to a power supply 101 and the gas supply 108 (e.g., carbon dioxide). The control unit 102 is also connected to the trocar 200 by tubing 104 as well as the wash solution supply reservoir 106. Any number of tubes or conduits may be used to couple various elements to the trocar. The endoscope 103 with camera 105 is shown inserted into the trocar 200.

As an example, a single lumen 204 may be used to direct a wash solution 106 and pressurized gas 108 to an orifice at the distal end of the trocar. As such, the wash solution 106 and the gas 108 may be caused to flow selectively through the lumen 204, for example alternatively through the same single lumen 204 or at the same time.

The sensors 304 may be used to detect the presence of the scope which triggers an automated wash sequence. The wash sequence may comprise the priming of the system with a fixed quantity of solution (10 to 50 μl) and at the moment the sensor is triggered the pressurized gas may be activated for a fixed time period (e.g., 0.5 to 5 sec including intervening end points such as 0.5 to 1, 0.5 to 2, 0.5 to 3, 0.5 to 4, 1 to 2, or 1 to 3 secs, and the like). The gas may serve one or more purposes, for example, as a propellant to atomize the solution into a high-energy spray (which may last e.g., 0.1 to 0.5 sec including intervening endpoints) as it exits the orifice, and/or it may act a drying system to remove excess solution from the scope (which may last e.g., 0.5 to 5 sec including intervening end points). Other sequences may be used.

As an illustrative example, as shown in FIGS. 3C and 3B, a single cleaning orifice 206 may be disposed adjacent the distal end of the tube portion of the main body of a trocar and in fluid communication with the fluid channel to receive the wash solution, the gas, or both from the fluid channel and to allow the wash solution, the gas, or both to flow toward the cavity. One or more sensors 304 may be disposed on or in the tube portion of the main body between the cleaning orifice 206 and the head portion of the main body, the one or more sensors 304 configured to sense a position of the endoscope 103 within the cavity. Although various arrangements may be used, the sensors 304 may be disposed inline above or below the cleaning orifice 206 (FIGS. 5A-5B). Other arrangements include the sensors 304 being arranged along a longitudinal axis in line with the cleaning orifice 206.

The system may be used with minimal input from the operator hence the use of sensors to automatically detect the scope and activate the wash sequence. Other exemplary embodiments of this design replace the sensors with switches which the operator actuates to activate the wash. This design may be further simplified by the operator manually actuating valves to control the solution and gas supply thus removing the controller from the design. It is important to note that any combination of the above may be utilized in accordance with the present disclosure.

In an aspect, the controller may enable both operation of the unit and the level of washing to be defined by the user needs. Multiple modes of operation may be pre-programmed into the controller which may then be selected by the user. For example: if the type of procedure experiences a high rate of fogging then a de-fog only mode may be selected or if there is a large build-up of debris on the scope, for example, caused by the use of energy devices then a deep-clean mode may be activated which delivers a large wash volume to the scope. FIG. 14 describes or illustrates this process in flowchart form. Various modes of operation can be envisioned to address different types of cleaning modes in addition to different ways of interacting with the system. For example: some users may find it easier to perform a wash by positioning the scope at the wash sensor and holding the scope at this position while the controller goes through its programmed sequence whereas another user may prefer to control the wash steps e.g. positioning the scope at the wash sensor triggers a dry only sequence and to trigger a full clean the user has to retract the scope further into the trocar to activate the prime sensor then extend the scope to the wash sensor to perform the full clean.

Other alternate exemplary embodiments of the trocar design are possible to improve the performance of the system. For example, multiple orifice designs to create multi-directional sprays useful for scopes with angled faces or featured faces and use of small branches from the main lumen (which have built-in restrictions to reduce the flow) to provide multiple drying ports to improve the ability of the system to dry angled of features scope faces.

A significant challenge with a cleaning system using sprays is to eliminate or minimize the amount of residual moisture that remains in the scope lumen after the spray has ended. This residual moisture has the potential to contaminate the drying sequence resulting in an incomplete dry (water droplets on the scope lens) thus compromising the cleaning.

Careful design of the lumen such as minimizing the tortuosity of the lumen path and removing the potential areas for solution to collect may reduce the potential for residual moisture however it is difficult to remove completely.

The preferred design of the trocar of the present disclosure includes a mode for the purpose of performing a dry only. In this mode when a specific sensor is triggered the system performs a gas dry only. This dry only process can be extremely quick and is effective at removing a light build-up of moisture on the scope face including drops of residual moisture, condensation or blood transfer.

Another exemplary embodiment of the trocar of the present disclosure which is designed to tackle residual moisture is the use of a secondary lumen for gas which would be used only for drying. Switching from the main lumen after washing i.e. immediately after the majority of the spray has been delivered during washing would result in a quick and effective dry with the added benefit that the gas pressure could be reduced.

There is a desire to keep the outer diameter of a trocar as small as possible to minimize the size of the incision in the patient as larger incisions are known to be associated with increased pain and a higher risk of hernia. A challenge with the trocar design of the present disclosure is how to implement the lumen and orifice with minimal impact on the outer diameter of the trocar.

As shown in FIGS. 4A-4E, the orifice 206 may be angled to face the scope. As an example, the direction of the lumen 204 and/or 206 may be arranged such that the output angle of fluid from the orifice is greater than 90° (typically 110° to 170°) relative to the axis of the lumen 204 connecting to the orifice. Other angles and arrangements may be used, as illustrated in FIGS. 4C-4E. To create such a significant reorientation may require that the length of the orifice to be greater than or equal to the diameter of the orifice. As shown in FIG. 4A, certain arrangements may benefit from a thickness T1 that is greater than a respective outside diameter of the orifice 206. For a typical orifice diameter of 1.0 mm to 1.6 mm this adds significant thickness to the trocar. If the wall thickness is less than the length of the orifice, then the extent of reorientation is significantly reduced.

To achieve the thinnest possible trocar wall, the design of the present disclosure utilizes two different techniques. In the first technique as shown in FIGS. 4C, 4D and 4E, the circular x-section of the trocar is maintained, the scope lumen is positioned eccentric to the center of the trocar. The cleaning lumen is located within the thickest part of the trocar wall. As the lumen approaches the distal end of the trocar it is reversed in direction before existing through the orifice. Using this approach, the orifice only requires redirection of the spray to be less than 90° (typically 20° to 70°) meaning that the wall thickness may be less than the orifice diameter as shown in FIG. 4C where T2<the respective outside diameter of the orifice. In the second technique the scope lumen is kept concentric with the outer diameter and the outer diameter of the trocar is locally thickened to create a rib running the length of the trocar. The cleaning lumen and sensor strip are positioned within this rib in stacked configuration with the sensor strip positioned between the inner wall of the trocar and the cleaning lumen. This separation naturally creates the required length for the orifice to direct the spray.

One aspect of the system design is the ability to reliably detect the position of the scope within the trocar given the sources of variation in the different types of scopes commercially available e.g. scopes are available from arrange of different manufacturers, in different specifications such as viewing angle and light pattern and the use of different lighting sources such as halogen or LED.

One embodiment uses light receptive sensors to detect the emitted light from the scope which provide an analogue output in response to the level of light incident upon the sensor. Other types of sensors considered include photo-reflective, through-beam and inductive proximity. The light receptive sensors provide the best balance in terms of low package size, low cost and simplicity.

To account for the variation in sensors and the different levels of light (pattern and brightness) from different scopes it is beneficial to calibrate the system on first use. To achieve this, the control unit monitors incident light on the first scope insertion and based upon the peak level measured from the sensor one can apply a calibration factor to normalize the sensors signal or adjust the trigger threshold to set the voltage at which each sensor triggers e.g. using a pre-defined formula such as given by Threshold=80%×Peak Voltage. In addition to using a dynamic threshold to account for variation one can also use the different transitions of the sensor to suit a particular purpose. For example, when one simply wants to detect the presence of a scope one can apply a low threshold to the sensor signal which provides a very sensitive signal of scope presence; however, where one wants to detect when a sensor has reached a position one can use the off transition i.e. when the scope has passed the sensor and the light is cut off.

In one embodiment the sensors are located on the dry side of the trocar (behind the inner wall of the trocar) for isolation from the fouling material and wash solution thus the trocar wall is manufactured from a transparent material such as polycarbonate or polypropylene. It is then possible to feature the wall of the trocar to create lenses to either capture additional light (radially and axially) improving the sensitivity of the sensors or to improve the positional sensitivity of the sensors by capturing light preferentially in the radial axis. Both techniques are useful in the trocar design e.g. the purpose of the ‘scope present’ sensor is to detect a scope so benefits from a lens to capture more light and the ‘wash’ sensor is to trigger a wash at a precise location so benefits from a shaped lens.

One aspect of the system design is providing feedback to the user to help them position the scope in the right position for cleaning. The sensors ensure that the wash cycle is triggered at the right time however because the scope positioning is manual there exists significant opportunity for the user to stop the scope outside of the optimal position. In this case it is possible that the wash efficacy will be compromised e.g. the scope is out of position such that it covers the wash port then no washing will occur. To aid the user target this position reliably it is beneficial to provide feedback such that the user can quickly get close to the approximate position then carefully locate the optimal position e.g. allow the user to quickly retract the scope and be alerted that they are close allowing them to slow the scope move in preparation for stopping.

One solution to this is audible feedback or visual feedback e.g. flashing lights on the control unit or a positional indicator overlaid on the scope display.

The current trocar sensors may be used to give a very coarse estimate of position e.g. warning sensor to give an alert that about to reach wash position followed by the wash position sensor altering the user to stop. Due to the analogue nature of the sensors it is possible to interpolate the actual position of the sensor which provides a finer (higher resolution) estimate of position. This information can be used to provide improved feedback to the user. For example: this positional information may be used to vary the tone of an audible signal or change the rate of beeping (like the reverse sensor in an automobile) thus providing a continuously variable feedback to the user until they reach the target position.

For an effective cleaning cycle, it has been found that the optimal position for washing and drying is at the distal end of the trocar. In this position the debris from the washing and drying process may be effectively expelled from the trocar. This prevents the build-up of debris within the trocar which can cause refouling of a clean scope and makes the scope drying process more efficient due to the minimal wash solution remaining after a wash.

One aspect of the trocar of the present disclosure uses an initial burst of gas (termed de-fog mode) to clean the scope. This burst of gas has been shown to be highly effective at cleaning scopes when the fouling material doesn't leave a film on the surface of the scope such as condensation, splashing from irrigation solution or blood. For all other types of fouling this burst of gas is highly effective at removing the bulk of the foulant from the scope which makes the subsequent wash process easier and more efficient.

One aspect of the system design may comprise providing an easy to use device that does not require the user to press any buttons for the process of calibration, scope insertion or cleaning cycle. In some embodiments of the present system the trocar comprises a “present” sensor (FIG. 7 ) for the purpose of detecting the initial insertion of the scope. Other devices and systems may be used.

By monitoring the rate of change in the sensor signal the control unit may determine if the scope is being inserted into the trocar or being removed. i.e. if the sensor signal is increasing the scope if being inserted and if the sensor signal is decreasing then the scope if being removed.

By using this sensor, the system may disable the washing cycle when the scope is first inserted into the trocar and perform a different function such as the calibration sequence detailed earlier. And conversely, the system may use this sensor input to disable the washing cycle when a scope if being removed from the trocar e.g. when the user is changing the scope type which is a common occurrence during a procedure.

As described earlier, the system may be used with scopes with different viewing angles (FIG. 9 ). The variation in scope angle poses a challenge for the design of the system when only using one cleaning orifice because the relationship between the cleaning orifice and the scope face to be cleaned changes significantly.

One solution to this challenge is the use of a plurality of orifices arranged circumferentially within the trocar providing effective washing irrespective of the scope rotation however this adds significantly complexity to the design of the trocar and potentially an increase in the consumption of wash solution and gas. A design that retains the simplicity of a single orifice trocar while providing an effective wash is highly preferred.

There are at least two challenges with angled scopes: 1) the relationship between the scope face to be cleaned and the fixed orifice changes and 2) the angled scopes are asymmetric meaning that if the scopes are rotated the relationship between the scope face and the orifice changes. These challenges are described in FIG. 9 . FIGS. 9A-9D show a typical range of scope angles commercially available. FIG. 9E demonstrates that when the orifice is positioned for the optimal relationship for a 0° scope then the positioning is compromised for an angled scope. FIG. 9F shows the inverse situation where the orifice is positioned to suit a 45° scope and the relationship to the 0° scope is compromised.

The angled scopes pose the additional challenge in that as they are rotated within the trocar the orientation of the scope face (to be cleaned) to the orifice changes. FIG. 9G shows the scope in the ideal relationship with the orifice directly aligned to the scope whereas FIG. 9H shows the scope in the worst orientation which, in this example, the orifice does not impinge on the scope meaning the scope clean would be ineffective. FIG. 9I shows the interim case where the scope is rotated mid-way between the optimal and worst-case orientations to help visualize the decrease in cleaning efficacy expected as the scope is rotated angle changes.

To address these problems, the trocar may comprise the following features: The spray orifice geometry (FIG. 10A-10B) is changed to create a shaped spray which spreads the spray out over a large area to accommodate the differences between the scopes e.g. by using a rectangular or elliptical orifice the spray pattern can be flattened from a cone to a fan.

One solution to the rotation of the scopes is to ask the user to twist the scope to the optimal position at the same time that the scope is retracted into the trocar for washing. To aid this process graphics 212 can be printed onto the exterior of the trocar (FIG. 13 ) to give the user a visual cue to alignment.

The interior of the trocar (FIGS. 11-12 ) is featured to provide visual indication of position such that if the user has adequate visibility (or if visibility improves during the washing sequence) the user can see this target allowing the user to adjust the position of the scope for optimal cleaning. These features can be markings 214 that are embossed or printed onto the surface of the trocar or can be incorporated into the body of the trocar such a way that the features 216 reflect the light from the scope to provide a highly visible target.

The present disclosure provides functions and features that may be utilized to efficiently and effectively clean an endoscope during a procedure. The cleaning system of the present disclosure utilizes a single trocar which allows a user to clean an endoscope during a procedure with minimal requirements on the user.

The present disclosure may utilize a trocar with single lumen and orifice. The single lumen and orifice of the present disclosure provides a method of channeling a wash solution and pressurized gas from a common inlet port through a common lumen to a common spray orifice for the purpose of cleaning an endoscope.

The present disclosure may utilize an endoscope cleaning system comprising a wash solution and pressurized gas. The wash solution and pressurized gas may be utilized in a method of delivering a small volume of wash solution to a spray orifice, atomizing the solution into a transient spray followed by a continuous flow of gas for the purpose of cleaning an endoscope.

The present disclosure includes a method for minimizing and addressing residual moisture on the lens. More specifically, the present disclosure utilizes a method for minimizing residual moisture build-up in a common lumen to prevent the residual moisture compromising the drying portion of the cleaning cycle. Pressurized gas without washing solution may be utilized for drying.

As shown in FIG. 15 the lumen is designed and manufactured in such a way to remove any edges or steps in the fluid path which can trap or retain moisture as the wash solution is propelled through the lumen. As shown in FIGS. 15A-15C, a typical lumen design may allow moisture (designated with *) to get trapped in areas on the lumen. As shown in FIGS. 15D-15F, a two-piece design may minimize retention of moisture. As an example, edges may be removed from the fluid path, which may minimize retention or buildup of moisture when compared to a stepped or hard edge design. Such lumen may be created using injection molding for example. However, other methods may be used.

The present disclosure comprises a method for creating a reverse spray angle in a thin-walled device. Methods are described for creating a spray angle that enables the spray direction to be redirected to a greater angle than if simply using the length of the orifice as the primary means of re-direction.

The present disclosure includes a method for detecting an endoscope using its emitted light. More specifically, the present disclosure utilizes a method of detecting the presence and position of an endoscope using the light emitted from the endoscope for the purpose of automatically triggering the respective step in the cleaning cycle. This eliminates the user having to initiate the process.

The present disclosure also includes a method for automatically calibrating sensors. More specifically, a method for automatically calibrating the sensors during the initial endoscope insertion into the trocar provides for accommodating the variation in endoscope lighting caused by endoscope type, endoscope angle, light source and light brightness for the purpose of achieving a reliable and repeatable cleaning system.

The present disclosure also comprises methods to aid the user in positioning the scope for cleaning. Methods are described for providing audible and visual feedback to the user for the purpose of aiding the user in positioning the endoscope in the optimal position for an effective cleaning cycle.

The present disclosure also comprises controlled spray geometry for addressing the challenges with angled endoscopes. A method and associated system is utilized to control the spray geometry from the cleaning orifice for the purpose of creating a spray pattern that is suited to different endoscope angles.

The present disclosure still further includes methods for improving the sensitivity of the endoscope's sensors to light level and position. A method utilizing different lens designs created in the wall of the trocar may improve the sensitivity at detecting the presence of an endoscope and to improve the sensitivity at the detecting the position of the endoscope.

The present disclosure still further comprises a method for interpolating the endoscope position between sensors for improved user feedback. A method using the analogue output from the endoscope sensors to estimate the scope position will result in a higher resolution than provided by the sensor signal alone for the purpose of providing improved feedback to the user on endoscope position.

Intraoperative endoscope cleaning systems are disclosed herein. An example intraoperative endoscope cleaning system may comprise a control unit, a wash solution reservoir, a gas supply connected to the control unit and a camera port (e.g. a trocar). The trocar may be connected to the control unit and the wash solution reservoir and configured for facilitation of an endoscope into a body of a patient and for cleaning the endoscope during use.

The example trocar may comprise a main body, an inlet port, a fluid channel, a cleaning orifice and one or more sensors.

The main body of the trocar may comprise a head portion and an elongate hollow tube portion extending from the head portion and terminating at a distal end of the main body, wherein the tube portion defines a cavity configured to receive an endoscope.

A connector port may be disposed through the head portion of the main body and configured to receive a bulkhead connector. The distal end of the tube portion may comprise a shaped end having edges. For example, the shaped end may comprise a first edge and a second edge opposite the first edge. The first edge may extend further from the head portion than the second edge.

The inlet port may comprise a single inlet port or a plurality of inlet ports. The inlet port may be disposed through the head portion of the main body and configured to receive a wash solution, a gas or both. The wash solution may comprise a buffered solution comprising a bio-compatible surfactant. The gas may comprise carbon dioxide or other gases. The wash solution and gas may be selectively received or may be received successively. Other materials suitable for cleaning medical devices may be used.

The fluid channel may comprise a single fluid channel or a plurality of fluid channels. The fluid channel may be disposed in or adjacent the tube portion of the main body and in fluid communication with the inlet port to receive the wash solution, the gas or both from the inlet port.

The cleaning orifice may comprise a single cleaning orifice only or a plurality of cleaning orifices. The cleaning orifice may be disposed adjacent the distal end of the tube portion of the main body and in fluid communication with the fluid channel to receive the wash solution, the gas, or both from the fluid channel and to allow the wash solution, the gas, or both to flow toward the cavity. The cleaning orifice may be disposed adjacent the first edge. The cleaning orifice may comprise an angled port formed through at least part of the tube portion of the main body. The cleaning orifice may be thin-walled. The cleaning orifice may comprise shaped orifice designs.

One or more sensors may be disposed on or in the tube portion of the main body between the cleaning orifice and the head portion of the main body. The sensors may be disposed adjacent the fluid channel. The sensors may be configured to sense a position of the endoscope within the cavity. The sensors may comprise a flexible circuit board. The sensors may be self-calibrating. The sensors may be coupled with lenses. The sensors may be in communication with the control unit. The control unit may be configured to execute one or more cleaning processes in response to feedback received from the sensors. The execution of the one or more cleaning responses may be automatic. The control unit may be configured to provide ease of use features such as visual and audible feedback to the user to aid in positioning of the endoscope. The one or more cleaning processes may be or comprise a de-fog operation, a priming operation or a wash and dry operation.

The de-fog operation may comprise expelling a burst of gas through the cleaning orifice. The de-fog operation may be triggered as the endoscope is retracted into the tube portion and passes one or more of the sensors, for example the distal-most sensor.

The priming operation may comprise loading an amount of the wash solution into the fluid channel. The priming operation may be triggered as the endoscope is retracted into the tube portion beyond a threshold.

The wash and dry operation may comprise expelling the wash solution from the cleaning orifice. The wash and dry operation may be followed by gas for drying. The wash and dry operation may be improved over conventional methods. The wash and dry operation may be five seconds or less, four seconds or less, or three seconds or less. Other times may be achieved.

Methods of cleaning endoscopes during procedures utilizing trocars are described herein. An example method may comprise defogging the endoscope, priming the cavity, washing the endoscope, drying the endoscope or combinations thereof. The example method, or certain portions of the example method, may be executed automatically. Certain procedures may be included or excluded. For example, a method may comprise defogging without priming or washing. Other procedures may be used or customized.

Although shown and described in what is believed to be the most practical and preferred embodiments, it is apparent that departures from specific designs and methods described and shown will suggest themselves to those skilled in the art and may be used without departing from the spirit and scope of the invention. The present disclosure is not restricted to the particular constructions described and illustrated but should be constructed to cohere with all modifications that may fall within the scope of the appended claims. 

What is claimed is:
 1. A trocar for an intraoperative endoscope cleaning system, the trocar comprising: a main body comprising a head portion and an elongate hollow tube portion extending from the head portion and terminating at a distal end, wherein the elongate hollow tube portion defines a cavity configured to receive an endoscope; a single inlet port disposed through the head portion of the main body and configured to selectively receive a wash solution, a gas, or both; a single fluid channel disposed in or adjacent the elongate hollow tube portion of the main body and in fluid communication with the single inlet port to receive the wash solution, the gas, or both from the single inlet port; a single cleaning orifice disposed adjacent the distal end of the elongate hollow tube portion of the main body and in fluid communication with the single fluid channel to receive the wash solution, the gas, or both from the single fluid channel and to expel the wash solution, the gas, or both into the cavity; and a sensor disposed on or in the elongate hollow tube portion of the main body adjacent to the single cleaning orifice, the sensor configured to sense a position of the endoscope within the cavity by detecting light emitted by the endoscope.
 2. The trocar of claim 1, wherein the distal end of the elongate hollow tube portion of the main body comprises a shaped end having a first edge and a second edge opposite the first edge, wherein the first edge extends further from the head portion than the second edge.
 3. The trocar of claim 2, wherein the single cleaning orifice is disposed adjacent to the first edge.
 4. The trocar of claim 3, wherein the single cleaning orifice comprises an angled port formed through at least part of the elongate hollow tube portion of the main body.
 5. The trocar of claim 1, wherein the single cleaning orifice comprises a thin-walled orifice.
 6. The trocar of claim 1, wherein the single cleaning orifice comprises a shaped orifice design.
 7. The trocar of claim 1, wherein the single cleaning orifice comprises an angled port formed through at least part of the elongate hollow tube portion of the main body, the angled port being proximally directed such that the angled port is configured to expel the wash solution, the gas, or both into the cavity in a direction toward a distal face of the endoscope disposed proximal of the angled port.
 8. The trocar of claim 1, wherein the sensor is disposed adjacent the fluid channel.
 9. The trocar of claim 1, wherein the sensor is mounted on a flexible circuit board.
 10. The trocar of claim 1, wherein the sensor is self-calibrating.
 11. The trocar of claim 1, further comprising a lens coupled with the sensor.
 12. The trocar of claim 1, further comprising a connector port disposed through the head portion of the main body and configured to receive a bulkhead connector.
 13. The trocar of claim 1, wherein an interior wall defining the single fluid channel comprises smooth, unstopped edges.
 14. The trocar of claim 1, further comprising a control unit operatively coupled to the one or more sensors, the control unit configured to automatically trigger delivery of the wash solution, the gas, or both to the single inlet port to be subsequently expelled into the cavity via the single cleaning orifice in response to the one or more sensors sensing that a distal face of the endoscope is near the distal end of the elongate hollow tube portion.
 15. The trocar of claim 14, wherein the control unit is further configured to provide audible or visual feedback to a user in relation to the position of the endoscope as sensed by the one or more sensors as the user is retracting the endoscope within the cavity.
 16. The trocar of claim 1, wherein the sensor is disposed behind an inner wall of the elongate hollow tube portion, and at least a portion of the hollow tube portion is formed of a transparent material that is configured to capture the light emitted by the endoscope for detection by the sensor.
 17. The trocar of claim 1, wherein the sensor is a first sensor, and further comprising a second sensor disposed on or in the elongate hollow tube portion of the main body at a position proximal of the first sensor, the second sensor configured to detect a presence of the endoscope in the cavity.
 18. A trocar for an intraoperative endoscope cleaning system, the trocar comprising: a main body comprising a head portion and an elongate hollow tube portion extending from the head portion and terminating at a distal end, wherein the elongate hollow tube portion defines a cavity configured to receive an endoscope, wherein the distal end of the elongate hollow tube portion includes an angled end having a first edge and a second edge, the first edge being opposite to the second edge and extending further from the head portion than the second edge; an inlet port disposed through the head portion of the main body and configured to alternatively receive a wash solution and a dry gas; a fluid channel disposed in or adjacent the elongate hollow tube portion of the main body and in fluid communication with the inlet port to receive the wash solution and the dry gas from the inlet port; a cleaning orifice disposed adjacent to the first edge of the distal end of the elongate hollow tube portion of the main body at a position distal to the second edge, the cleaning orifice being in fluid communication with the fluid channel to receive the wash solution and the dry gas and to expel the wash solution and the dry gas into the cavity with the dry gas propelling the wash solution into the cavity; and a sensor disposed on or in the elongate hollow tube portion of the main body at a position distal to the second edge, the sensor configured to sense a position of the endoscope within the cavity.
 19. The trocar of claim 18, wherein the distal end of the elongate hollow tube portion of the main body comprises an angled end having a first edge and a second edge opposite the first edge, wherein the first edge extends further from the head portion than the second edge, and wherein the cleaning orifice is disposed adjacent the first edge.
 20. The trocar of claim 19, wherein the cleaning orifice comprises an angled port formed through at least part of the elongate hollow tube portion of the main body.
 21. The trocar of claim 18, wherein the cleaning orifice comprises a thin-walled orifice.
 22. The trocar of claim 18, wherein the cleaning orifice comprises a shaped orifice design.
 23. The trocar of claim 18, wherein the cleaning orifice comprises an angled port formed through at least part of the elongate hollow tube portion of the main body, the angled port being proximally directed such that the angled port is configured to expel the wash solution and the dry gas into the cavity in a direction toward a distal face of the endoscope disposed proximal of the angled port.
 24. The trocar of claim 18, wherein the sensor is disposed adjacent to the fluid channel.
 25. The trocar of claim 18, wherein the sensor is mounted on a flexible circuit board.
 26. The trocar of claim 18, wherein the sensor is self-calibrating.
 27. The trocar of claim 18, further comprising a lens coupled with the sensor.
 28. The trocar of claim 18, further comprising a connector port disposed through the head portion of the main body and configured to receive a bulkhead connector.
 29. The trocar of claim 18, wherein an interior wall defining the fluid channel comprises smooth, unstopped edges.
 30. The trocar of claim 18, the cleaning orifice configured to deliver the dry gas into the instrument lumen while the wash solution is being delivered to atomize the wash solution.
 31. The trocar of claim 18, wherein the sensor is disposed behind an inner wall of the elongate hollow tube portion, and at least a portion of the hollow tube portion is formed of a transparent material that is configured to capture the light emitted by the endoscope for detection by the sensor.
 32. The trocar of claim 18, wherein the sensor is a first sensor, and further comprising a second sensor disposed on or in the elongate hollow tube portion of the main body at a position proximal of the first sensor, the second sensor configured to detect a presence of the endoscope in the cavity.
 33. An intraoperative endoscope cleaning system, comprising: a control unit; a wash solution reservoir; and a trocar connected to the control unit and the wash solution reservoir, wherein the trocar is configured for facilitation of an endoscope into a body of a patient and for cleaning the endoscope during use, the trocar further comprising: a main body comprising a head portion and an elongate hollow tube portion extending from the head portion and terminating at a distal end, wherein the elongate hollow tube portion defines a cavity configured to receive an endoscope, wherein the distal end of the elongate hollow tube portion includes an angled end having a first edge and a second edge, the first edge being opposite to the second edge and extending further from the head portion than the second edge; a single inlet port disposed through the head portion of the main body and configured to selectively receive a wash solution from the wash solution reservoir, a gas from a gas supply, or both; a single fluid channel disposed in or adjacent the elongate hollow tube portion of the main body and in fluid communication with the inlet port to receive the wash solution, the gas, or both from the inlet port; a single cleaning orifice disposed adjacent to the first edge of the distal end of the elongate hollow tube portion of the main body at a position distal to the second edge, the single cleaning orifice and in fluid communication with the fluid channel to receive the wash solution, the gas, or both from the fluid channel and to allow the wash solution, the gas, or both to flow toward the cavity; and a sensor disposed on or in the elongate hollow tube portion of the main body at a position adjacent to the single cleaning orifice, the sensor configured to sense a position of the endoscope within the cavity by detecting light emitted by the endoscope.
 34. The system of claim 33, wherein the distal end of the elongate hollow tube portion of the main body comprises an angled end having a first edge and a second edge opposite the first edge, wherein the first edge extends further from the head portion than the second edge.
 35. The system of claim 34, wherein the cleaning orifice is disposed adjacent the first edge.
 36. The system of claim 35, wherein the cleaning orifice comprises an angled port formed through at least part of the elongate hollow tube portion of the main body.
 37. The system of claim 33, wherein the cleaning orifice comprises a thin-walled orifice.
 38. The system of claim 33, wherein the cleaning orifice comprises a shaped orifice design.
 39. The system of claim 33, wherein the cleaning orifice comprises an angled port formed through at least part of the elongate hollow tube portion of the main body.
 40. The system of claim 33, wherein the sensor is disposed adjacent the fluid channel.
 41. The system of claim 33, wherein the sensor is mounted on comprise a flexible circuit board.
 42. The trocar of claim 33, wherein the sensor is self-calibrating.
 43. The trocar of claim 33, further comprising a lens coupled with the sensor.
 44. The system of claim 33, further comprising a connector port disposed through the head portion of the main body and configured to receive a bulkhead connector.
 45. The system of claim 33, wherein the wash solution comprises a buffered solution comprising a bio-compatible surfactant.
 46. The system of claim 33, wherein the one or more sensors are in communication with the control unit, and wherein the control unit is configured to execute one or more cleaning processes in response to feedback received from the one or more sensors.
 47. The system of claim 46, wherein the control unit is further configured to provide visual or audible feedback in relation to the position of the endoscope.
 48. The system of claim 46, wherein the one or more cleaning processes comprises a de-fog operation.
 49. The system of claim 48, wherein the de-fog operation comprises expelling a burst of gas through the cleaning orifice.
 50. The system of claim 49, wherein the de-fog operation is triggered as the endoscope is retracted into the elongate hollow tube portion and passes a sensor of the one or more sensors.
 51. The system of claim 46, wherein the one or more cleaning processes comprises a priming operation.
 52. The system of claim 51, wherein the priming operation comprises loading an amount of the wash solution into the fluid channel.
 53. The system of claim 51, wherein the priming operation is triggered as the endoscope is retracted into the elongate hollow tube portion beyond a threshold as detected by the one or more sensors.
 54. The system of claim 46, wherein the one or more cleaning processes comprises a wash and dry operation.
 55. The system of claim 54, wherein the wash and dry operation comprises expelling the wash solution from the cleaning orifice followed by the gas for drying.
 56. The system of claim 55, wherein the wash and dry operation is less than five seconds.
 57. The system of claim 33, wherein the one or more sensors are in communication with the control unit, and wherein the control unit is configured to automatically execute one or more cleaning processes in response to feedback received from the one or more sensors.
 58. The system of claim 57, wherein the control unit is further configured to provide visual or audible feedback in relation to the position of the endoscope.
 59. The system of claim 33, further comprising the gas supply, the gas supply configured to supply the gas at a pressure of between 10 to 30 psi.
 60. The system of claim 59, where the gas comprises carbon dioxide.
 61. The system of claim 33, wherein the sensor is disposed behind an inner wall of the elongate hollow tube portion, and at least a portion of the hollow tube portion is formed of a transparent material that is configured to capture the light emitted by the endoscope for detection by the sensor.
 62. The system of claim 33, wherein the sensor is a first sensor, and further comprising a second sensor disposed on or in the elongate hollow tube portion of the main body at a position proximal of the first sensor, the second sensor configured to detect a presence of the endoscope in the cavity. 